2021-22 Pre-65 Benefits Open Enrollment and Coverage Details
"Discover the key information for the 2021-22 pre-65 benefits open enrollment, including dates, coverage details, COVID-19 updates, medical and prescription drug benefits, and how to enroll. Learn about important healthcare changes and opportunities to optimize your benefits."
Download Presentation
Please find below an Image/Link to download the presentation.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author. If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.
You are allowed to download the files provided on this website for personal or commercial use, subject to the condition that they are used lawfully. All files are the property of their respective owners.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author.
E N D
Presentation Transcript
2021-22 PRE-65 BENEFITS OPEN ENROLLMENT May 31, 2021 through June 13, 2021
INTRODUCTION Shelli Hulsing Client Advocate, Senior Service Specialist
AGENDA Open Enrollment COVID-19 Update Medical Plans Prescription Drug Plans Dental Plan How to Enroll
WELCOME TO OPEN ENROLLMENT Open enrollment begins May 31, 2021 through June 13, 2021 Open enrollment is your once-a-year opportunity to review and make changes to your current benefit elections. Changes you make during open enrollment will be effective September 1, 2021.
CORONAVIRUS/COVID-19 UNITEDHEALTH CARE COVERAGE COVID-19 Vaccine. The COVID-19 vaccine and its administration is covered at no out-of-pocket cost to you throughout the public health emergency. After the public health emergency ends, the COVID-19 vaccine and its administration will be covered as an Affordable Care Act (ACA) preventive service at no member cost-share. Covering diagnostic tests for COVID-19. Members continue to have no cost-share for appropriate diagnostic testing during the public health emergency. Important to continue seeking routine care from your providers, even in these uncertain times, to maintain your health and stay informed.
MEDICAL AND PRESCRIPTION DRUG BENEFITS MEDICAL
MEDICAL PLAN SUMMARY $1,250 PLAN In-Network Out-of-Network Calendar year deductible* (January 1 December 31) Individual Family Out-of-pocket maximum Individual Family Coinsurance Office visits Primary care physician Specialist Designated specialties Preventive care Hospital services Inpatient Outpatient Urgent care $1,150 to $1,250 $2,300 to $2,500 $2,200 to $2,500 $4,400 to $5,000 $4,800 to $5,000 $9,600 to $10,000 80% $9,600 $19,200 60% $30 to $35 copay $50 to $55 copay $30 to $35 copay 100%, deductible waived 60% 60% 80% 60% $55 copay, deductible waived 60% $150 copay, then 80% Emergency room Deductible applies before coinsurance unless otherwise noted
MEDICAL PLAN SUMMARY $2,500 PLAN NO CHANGES! In-Network Out-of-Network Calendar year deductible* (January 1 December 31) Individual Family Out-of-pocket maximum Individual Family Coinsurance Office visits Primary care physician Specialist Designated specialties Preventive care Outpatient Therapy PT/OT/ST Chiropractic Cardiac Pulmonary Urgent care $2,500 $5,000 $5,000 $10,000 $7,350 $14,700 70% $14,700 $29,400 60% $50 copay $70 copay $50 copay 60% 100%, deductible waived 60% 70% (60 visits combined) 70% (30 visits) 70% (18 visits) 70% (18 visits) $70 copay, then deductible/coinsurance $100 copay, then deductible/coinsurance 60% 60% Emergency room *Deductible applies before coinsurance unless otherwise noted
MEDICAL PLAN SUMMARY $3,600 PLAN NO CHANGES! In-Network Out-of-Network Calendar year deductible* (January 1 December 31) Individual Family Out-of-pocket maximum Individual Family Coinsurance Office visits Primary care physician <Age 19 Specialist Designated specialties Preventive care Outpatient Therapy PT/OT/ST Chiropractic Cardiac Pulmonary Urgent care $3,600 $7,050 $7,200 $14,100 $4,250 $8,150 90% $12,700 $25,400 80% 90% 80% 100%, deductible waived 80% 90% (60 visits combined) 90% (30 visits) 90% (18 visits) 90% (18 visits) 90% 80% 80% 90% Emergency room *Deductible applies before coinsurance unless otherwise noted
IN-NETWORK PRESCRIPTION DRUG BENEFITS NO CHANGES! $1,250 Plan $2,500 Plan $3,600 Plan Retail (In-Network) 30-day Supply Tier 1 Tier 2 Tier 3 Tier 4 Specialty Rx $15 copay $60 copay $100 copay $200 copay 30% coinsurance ($12 min/$45 max) 30% coinsurance ($55 min/$110 max) 30% coinsurance ($75 min/$150 max) 25% coinsurance ($125 min/$250 max) Deductible, then plan pays 90% Mail Order (In-Network) 90-day supply Tier 1 Tier 2 Tier 3 $45 copay $180 copay $300 copay 30% coinsurance ($25 min/$135 max) 30% coinsurance ($165 min/$330 max) 30% coinsurance ($225 min/$450 max) Deductible, then plan pays 90%
NO DENTAL BENEFITS UHC CHANGES! In-Network Out-of-Network Deductible (per family) $25 $50 Maximum benefit (per calendar year) $5,000 Preventive services Oral examinations X-rays Prophylaxis (cleaning) 100% 70% Deductible waived Deductible waived Basic services Amalgams (fillings) Extractions Periodontics/endodontics 80% 70% Deductible waived Deductible applies Major services Crowns Dentures Fixed bridges Implants 50% 50% Deductible applies Deductible applies Orthodontia Up to age 19 $1,000 per person/per lifetime 50% 50% Deductible applies Deductible applies
OPEN ENROLLMENT INSTRUCTIONS If you are making election changes or your information has changed, please complete the Pre-65 Enrollment/Change Form that was included in the open enrollment materials that were sent to you and return to: Westside Human Resources 909 South 76thStreet Omaha, NE 68114 If you are not making any changes, your current elections will roll forward If you have any questions, you may contact Alice Dahir in Human Resources either by phone or email: 402-390-2144 dahir.alice@westside66.net
This benefit summary is intended only to provide you with a brief overview of your benefits. It is not a contract and should not be relied upon to fully determine your coverage. Refer to your Summary Plan Description for an exact description of the services/supplies that are covered, exclusions and other conditions of coverage.
